Steve Innes, H Simon Schaaf, Kim Gp Hoek, Helena Rabie, Mf Cotton
{"title":"UNSUSPECTED FATAL DRUG-RESISTANT TUBERCULOSIS IN A CLOSELY MONITORED CHILD: A PLEA FOR IMPROVED SOURCE-CASE TRACING AND DRUG SUSCEPTIBILITY TESTING.","authors":"Steve Innes, H Simon Schaaf, Kim Gp Hoek, Helena Rabie, Mf Cotton","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>We report a case of rapidly progressive miliary tuberculosis in a 21-month old HIV-infected girl exposed to tuberculosis, despite early access to highly active antiretroviral therapy and proven adherence to isoniazid chemoprophylaxis. Post mortem revealed multidrug-resistant tuberculosis. This case report illustrates the consequences of inadequate programmatic management of children exposed to an adult case of sputum smear-positive multidrug-resistant tuberculosis. Drug susceptibility testing of the adult source case should become standard of care for all children who have been in close contact with a case of sputum smear-positive tuberculosis, and the choice of chemoprophylactic agents should be based on the sensitivities of the source case organism.</p>","PeriodicalId":88334,"journal":{"name":"The Southern African journal of epidemiology & infection : official journal of the Sexually Transmitted Diseases, Infectious Diseases and Epidemiological Societies of Southern Africa","volume":"25 2","pages":"30-32"},"PeriodicalIF":0.0000,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919746/pdf/nihms222226.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Southern African journal of epidemiology & infection : official journal of the Sexually Transmitted Diseases, Infectious Diseases and Epidemiological Societies of Southern Africa","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
We report a case of rapidly progressive miliary tuberculosis in a 21-month old HIV-infected girl exposed to tuberculosis, despite early access to highly active antiretroviral therapy and proven adherence to isoniazid chemoprophylaxis. Post mortem revealed multidrug-resistant tuberculosis. This case report illustrates the consequences of inadequate programmatic management of children exposed to an adult case of sputum smear-positive multidrug-resistant tuberculosis. Drug susceptibility testing of the adult source case should become standard of care for all children who have been in close contact with a case of sputum smear-positive tuberculosis, and the choice of chemoprophylactic agents should be based on the sensitivities of the source case organism.
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